Information health policy 981207
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The document summarizes Taiwan's national health insurance system and recent reforms to pharmaceutical procurement. It describes how asymmetric information between patients and providers led the government to intervene through compulsory social health insurance. It also details a reform in Taipei City Hospital that introduced an open tendering system for pharmaceuticals, reducing costs and "information rents" but facing resistance from interest groups. The reform provides an example for other hospitals while managing political and quality concerns.
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C O A S TA L M E D I C A L C E N T E R
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2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e
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Competition and Qualityin Health Care MarketsFull text.docx
Competition and Quality
in Health Care Markets
Full text available at: http://dx.doi.org/10.1561/0700000024
Competition and
Quality in Health
Care Markets
Martin Gaynor
H. John Heinz III School of Public Policy and
Management, Carnegie Mellon University and
National Bureau of Economic Research,
Leverhulme Centre for Market and Public Organisation
University of Bristol UK
[email protected]
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Foundations and Trends R© in
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Full text available at: http://dx.doi.org/10.1561/0700000024
Foundations and Trends R© in
Microeconomics
Volume 2 Issue 6, 2006
Editorial Board
Editor-in-Chief:
W. Kip Viscusi
Vanderbilt University
Editors
Richard Carson, UC San Diego (environmental economics)
Joseph Harrington, Johns Hopkins University (industrial organization)
Tom Kniesner, Syracuse University (labor economics)
Mark V. Pauly, University of Pennsylvania (health economics)
David Wild.
Integrating Financing Schemes to Achieve Universal Coverage in Thailand: Anal...
1) Thailand achieved universal health care coverage in 2002 by introducing a tax-funded universal coverage scheme that provided insurance to 47 million people not covered by other programs.
2) The universal coverage policy aimed to remove financial barriers to healthcare through tax-funding and shifting costs from out-of-pocket payments to taxes.
3) Analysis found the universal coverage policy improved equity in healthcare use and financial risk protection, with healthcare use becoming more pro-poor and out-of-pocket costs becoming less regressive over time.
Medical devices equipped for the future
The document discusses disruptive changes underway in the medical devices industry that will transform it over the next 5 years. It identifies 5 major disruptors: 1) a power shift to payers and providers who are focusing more on cost and value-based evidence, 2) heightened regulatory scrutiny that is increasing compliance costs, 3) unclear sources of innovation as R&D spending yields diminishing returns, 4) new healthcare delivery models that are shifting care settings out of hospitals, and 5) a need to serve lower socioeconomic classes in developing markets. The disruptors threaten $34 billion in industry profits by 2020 but taking appropriate measures could help maintain revenue growth and offset margin declines, preserving significant value for medical device companies.
Medical Devices: Equipped for the Future?
Historically, the medical device industry has been highly attractive and relatively stable. As a consequence, established players have been able to compete successfully across the device spectrum, applying common business models and processes without much need for differentiation.
The future, however, is very different as disruptive change is underway. Companies will need to look at new segments and offer end-to-end solutions to secure additional revenue and maintain their profit margins.
Washington State BioMed Summit - Steve Halasey InHealth Presentation
Washington State BioMed Summit - Steve Halasey InHealth PresentationWashington State Biomedical Device Innovation Zone
The document summarizes Steve Halasey's presentation at the 2010 Washington State Biomedical Device Summit on healthcare reform and the future of medical technology innovation. It provides an overview of InHealth, including its mission to fund research on the impacts of medical technology. It discusses InHealth's $11 million in research grants and $1 million+ in educational programs. It then analyzes the Patient Protection and Affordable Care Act and its potential unintended consequences for medical device manufacturers. It stresses the importance of evidence-based research and industry engagement to help shape new agencies and programs under healthcare reform.Medicare Spending Report
The document discusses Medicare spending in the United States. It reports that Medicare spending was reduced to 0.2% in 2013 compared to 1.8% between 2009-2012. This decrease may have resulted from the recession limiting spending, delivery system reforms to improve quality while reducing local costs, or a focus on patient-centered care. Statistical data from Medicare budget reports is cited to support the claims around reduced spending.
The 10 Elements of Art1. Color2. Form3. Line4. Mass5. S.docx
The 10 Elements of Art:
1. Color
2. Form
3. Line
4. Mass
5. Shape
6. Space
7. Texture
8. Time and Motion
9. Value
10. Volume
The 10 Principles of Art:
1. Balance
2. Contrast
3. Emphasis
4. Focal Point
5. Pattern
6. Proportion
7. Rhythm
8. Scale
9. Unity
10. Variety
1
IN T R O D U C T I O N
This comprehensive case study serves as a basis for the exercises included throughout the
book.
Coastal Medical Center (CMC) is a licensed, 450-bed regional referral hospital
providing a full range of services. The primary service area is a coastal city and three coun-
ties, with a total population greater than 995,000, located in the Sunbelt. This tricounty
area has had one of the fastest population growth rates in the country for the past five
years. According to the local health planning council, the tricounty population is projected
to increase by 15 percent from 2015 to 2020. Appendix A, at the end of this case study,
provides detailed population statistics for the city and tricounty area.
The population growth rate for households (families) has been 1 to 2 percentage
points higher than the overall population growth. The growth rate of the population under
age 44 shows a young and growing community. Per capita (i.e., per person) income in the
tricounty area is high and increasing. As the population of the tricounty area increases, the
need for healthcare services is anticipated to increase. The area’s economy is largely supported
by manufacturing, with service companies and agriculture accounting for another 35 percent.
Unemployment is typically 6 percent. The overall poverty rate is 12.4 percent. A recent study
revealed that 40,000 city residents are below 125 percent of the established federal poverty level.
HE A LT H C A R E CO S T S
Healthcare costs in the region are high in comparison to healthcare costs in most other
areas in the state. In response to what they feel are excessively high healthcare costs, county
C O A S TA L M E D I C A L C E N T E R
C O M P R E H E N S I V E C A S E
S T U D Y
00_Harrison (2302).indb 1 2/18/16 4:12 PM10/12/2018 - RS0000000000000000000000574903 (Baylee Soper) - Essentials of Strategic Planning
in Healthcare
2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e
businesses recently formed a business coalition, hired a full-time executive, and publicly
stated their intent to achieve reduction in healthcare costs. The local press has expressed its
concern about the high cost of healthcare in the local community and consistently bashes
the area’s hospitals and physicians. The coalition refused to allow the three major medical
centers in the area to join, despite the fact that each is a major employer.
TH E CO M P E T I T I O N
CMC has two major competitors. Johnson Medical Center (JMC) is the larger of a two-
hospital for-profit healthcare system, and Lutheran Medical Center (LMC) is the larger of
a two-hospital, faith-based not-for-pro.
COST FACTORS & STRATEGIESReasons for increasing costs of healt.docx
COST FACTORS & STRATEGIES
Reasons for increasing costs of health care and
Some strategies for managing them
Page
No.
(1)
Admin/
Providers’
Strategies
(2)
Gov’t &
Payors' Strategies
(3)
Societal Factors
Which Increase
Costs
Advanced Technology
Aging Population
AIDS
Capitation
Cardiac Catheterization Lab
Care Mapping/Clinical Pathways
Case Rates and Per Diems
CAT Scanner
Change of Reimbursement System from Charge-Based, to Cost-Based, to Flat-Fee to Capitation
CON (Certificate of Need)
Concurrent Review
Cost Shifting
Cost Accounting System
Deductibles and Co-Payments
Defensive Medicine
Gatekeepers
Global Payments/ Bundling of Services
Increased Chronic, Long-Term Illnesses
Increased Long-Term Care
Inflation
Information Systems Technology
Joint Replacements
Just-in-Time Delivery
Large Jury Awards
Litigation
Medicaid Tightened Eligibility Restrictions
Mergers and Acquisitions
MRI
Neonatal ICU
Organ Transplants
Part-Time Workers Replacing Full-Time Workers
Payment System
Penalties for Services Outside of HMO Network w/o Prior Approval
Point of Care
Preadmission Certification and Second Opinions
Prospective Payment (DRG)
Prospective Payments
Provider Networks
Reengineering/Redesign
Retrospective Review
Rising Expectations
Shift to Outpatient Services
Steerage and Discounts
The Uninsured
Total Quality Management
NAME OF STUDENT:
�Introduction�
Never before have health care professionals faced such complex issues and practical dif-
ficulties trying to keep their organizations financially viable (see Perspective 1–1). With
C h a p t e r O n e
THE CONTEXT OF HEALTH CARE
FINANCIAL MANAGEMENT
Learning Objectives
AAfftteerr ccoommpplleettiinngg tthhiiss cchhaapptteerr,, yyoouu wwiillll bbee aabbllee ttoo::
� Identify key factors that have led to rising health care costs.
� Identify key approaches to controlling health care costs.
� Identify key ethical issues resulting from attempts to control costs.
Introduction
Rising Health Care Costs
The Payment System
Technology
The Aging Population
Prescription Drugs
Chronic Diseases
Compliance and Litigation
The Uninsured
Efforts to Control Costs
Efforts by Payors to Control Health Care
Costs
DRGs
Capitation
Global Payments
APCs
Cutting Delivery Costs
Shift to Outpatient Services
Cost Accounting Systems
Information Services Technology
Mergers and Acquisitions
Reengineering/Redesign
Cost Control Issues with Ethical
Overtones
Summary
Key Terms
Chapter Outline
063123098X-01.qxd 9/11/02 6:34 PM Page 1
turbulent changes taking place in payment, delivery, and social systems, health care pro-
fessionals are faced with trying to meet their organization’s health-related mission in an
environment of extreme cost pressure. In order to provide a context for the topics covered
in this text, .
PROJECT REPORT
The document discusses the healthcare industry and provides context for analyzing delays in patient discharge processes at a hospital from May to July 2015. It describes the objectives of studying delays, the sample size, tools used, and limitations. It then provides an overview of the global healthcare industry, key segments including hospitals, providers and professionals, models for healthcare delivery, and the market size of the industry in different regions. Porter's five forces model is applied to analyze competition in the healthcare industry.
Insight_Medtech
The document discusses four key concepts for medical device executives to understand in order to succeed in China's rapidly growing medical devices market. First, executives must seize China's market opportunities as the market is expected to reach $50 billion by 2017. Second, they must understand the Chinese government's important role in regulating the industry and procurement processes. Third, executives should monitor healthcare reforms that could impact market access. Fourth, local competition is growing, so companies must balance global and local strategies to stay competitive. The medical devices market in China offers great potential for growth but also complexity that executives must navigate carefully.
Ethics, Informatics and Obamacare
Surveys a series of ethical, economic, clinical and also safety issues relating to the application of informatics to healthcare, focusing especially on the role of informatics in the Patient Protection and Affordable Care Act. Talk presented in the University at Buffalo Clinical/Research Ethics Seminar - Ethics, Informatics and Obamacare, November 20, 2012. Slides are available here: http://ontology.buffalo.edu/13/ethics-informatics-obamacare.pptx
Market Forces in NHS
The document discusses whether market forces can make the NHS more efficient. It defines efficiency as using resources effectively to meet health needs. Market forces rely on competition and self-interest to allocate resources efficiently via price signals. However, the document argues that healthcare is unsuitable for a free market due to issues like asymmetric information between patients and providers, difficulty measuring quality, supplier-induced demand, and market failure. The document examines evidence that introducing market mechanisms in other countries and the US increased costs and inequitable access without improving quality. It concludes that market forces cannot make the NHS more efficient.
httpsdoi.org10.108009581596.2018.1444267COMMENTARY
https://doi.org/10.1080/09581596.2018.1444267
COMMENTARY
The opportunity cost of pharmaceutical price increases:
improving health by investing in education
Jonathan E. Fieldinga, Frederick J. Zimmermana and Kristin Calsadab
aCenter for Health advancement, Department of Health Policy & Management, Fielding School of Public Health,
uCla, los angeles, Ca, uSa; bDepartment of Health Policy & Management, Fielding School of Public Health, uCla,
los angeles, Ca, uSa
ABSTRACT
A federal law prohibits the US Government from negotiating pharmaceutical
prices. This law comes with an opportunity cost: resources spent on
unnecessarily highly priced drugs cannot be spent on other social goals. To
calculate the opportunity cost of this spending, this analysis first identified
a proxy for unnecessarily high pharmaceutical spending. We then estimated
the value of the outcomes which this money would produce if invested in an
alternative, high-value use. We estimated the excess price increases in a set
of 80 commonly prescribed drugs paid for by the Centers for Medicare and
Medicaid Services from 2010 to 2014. The value of price increases among
these drugs above the rate of medical inflation was $11.5 billion dollars. This
money has alternative uses, including some that promote health and other
social goals. This is the opportunity cost of unnecessarily high pharmaceutical
spending. Investment in high-school dropout prevention programs was
chosen as a measure of alternative uses for this spending because of the
importance of education as a social determinant of health and because
medical spending has been shown to specifically crowd out education
spending. Invested in programs to increase high-school graduation rates,
this money could create an additional 200,000 high-school graduates, which
in turn would generate an estimated $32 billion in returns (net present value)
to government and health improvements of up to 1 million quality-adjusted
life years (QALYs) per year of redirected expenditures.
Introduction
In 2014, medical care-related expenditures in the United States accounted for 17.8% of gross domestic
product (GDP), totaling over $3 trillion (Centers for Medicare & Medicaid Services, 2015b). Yet despite
outspending all other countries on a per capita basis, the United States ranks in the bottom third of
non-poor countries in life expectancy at birth and 27th out of 34 in life expectancy at age 60, ahead
only of far less wealthy countries like Mexico, Turkey, and Hungary (Scobie, 2015).
A report from the Institute of Medicine (Young & Olsen, 2010) documented $425 billion in excessive
costs-per-service delivered in 2009, including $130 billion in inefficiently delivered services, $190 billion
in excessive administrative costs, and $105 billion in prices that are too high. Although the report breaks
out inefficiency and administrative costs from prices, it should be remembered that all of these factors
increase the ave ...
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Information health policy 981207
- 1. Information and Health Care Policy: A Case of Taiwan By Yuntsai Chu Don-yun Chen 2009
- 7. 4. The Case of Taiwan’s National Health Insurance (NHI) NHI Act Passed Global Budget First Party Turn-over First Presidential Election NHI Launched 2G-NHI Planning Begun Political Events NHI Events 3.6 3.5 2.4 2.5 2.1 1.6 ENP 2005-2007 2002-2004 1999-2001 1995-1998 1992-1994 1989-1991 Year Sixth Fifth Forth Third Second First Legislative Yuan
- 8. Source: The Website of the DOH, http:// www.doh.gov.tw /statistic/
- 9. Reforming the Pharmaceutical Procurement Mechanism in Taiwan: An Appraisal of the Experience in Taipei City Hospital
- 10. Table One: The NHI Total and the Pharmaceutical Spending, 1998-2004 ($, in Billion of New Taiwan Dollars) Source: The DOH, http:// www.doh.gov.tw /statistic/ 24.90% 24.60% 24.40% 24.80% 25.40% 25.40% 24.80% (B)/(A) 15.70% 4.30% 6.90% 2.20% 3.10% 11.30% 12.90% Increase % 109 95 91 85 83 80 72 (B) Drug Spending 14.10% 3.30% 8.50% 4.80% 2.90% 8.80% 11.40% Increase % 438 384 371 342 326 317 291 (A) NHI Total 2004 2003 2002 2001 2000 1999 1998
- 11. Figure Three: Annual Pharmaceutical Purchases in Taiwan Unit: 100 Million NTD 32% 20% 48% 3%
- 13. 6. The “Black Hole” of Pharmaceutical procurement Figure Two: The Pharmaceutical Cost and its Revenue X : the cost of a single drug for the manufacture Y : the net revenue for the manufacture (i.e., the reasonable plus the abnormal profits in imperfect competition) Z : the price difference between the listed price and final sale price of a single drug, that is, the net revenue for the health provides (hospital, clinics and physicians) X+Y+Z = the listed price of a single pharmaceutical approved by the BNHI, namely, the reimbursement value a hospital obtains from the BNHI by filing its purchase. X Y Z A B C D C*
- 16. 9. The Outcome of The Reform (I) Table Four: The Pharmaceutical Profits of the United Hospital Unit: NT$ thousand Source: interim report by the United Hospital, 2005 28.99% 25.40% 24.14% 21.48% C/A 2.99% 11.12% 13.61% 16.94% Pharmaceutical Profitability (D/B) 40,205 179,543 210,779 450,000 Pharmaceutical Revenues (D) 1,303,196 1,434,869 1,338,414 2,205,758 Pharmaceutical Expense (C) 1,343,401 1,614,412 1,549,192 2,655,758 Pharmaceutical Income (B) 4,495,156 5,648,371 5,545,025 10,268,565 Total Income (A) Jan.~Jul. 2003 Jan.~Jul. 2004 Jan.~Jul. 2005 2005
- 17. 10. The Outcome of the Reform (II) Table Three: The Pharmaceutical Procurement in the Taipei United Hospital Source: interim report by the Health Bureau (2005) 1272 (100%) 1312 (100%) total 684 (53.8%) 699 (53.3%) Generic/ off-patent (domestic suppliers) 588 (46.2%) 613 (46.7%) Original/ patent 2005-2006 2003-2004 Items
- 21. Thanks for your Attention Questions are Welcomed